Program Letters of Agreements (PLAs) and External Rotation Agreements (RAs) are defined by the ACGME as, “written documents that address GME responsibilities between an individual accredited program and a site other than the sponsoring institution.” As the sponsoring institution, the University of Florida College of Medicine – Gainesville, FL, has a different governing board than clinical sites, requiring PLAs for accredited program rotations.
All PLAs must have rotation goals and objectives attached using this Rotation Goals and Objectives Template. Submit goals and objectives in a Word document.
Read below to select which PLA/RA template to choose. Scroll down for templates. Learn more about the PLA/RA process.
For questions, email DOCOM-GME-PLA@ufl.edu.
PLA Portal: Please submit all new PLA and RA requests with documentation here.
Types of Information needed to submit through the PLA portal link above.
FAQ
I have a three-year program with four rotations [e.g. 1) inpatient pediatrics, 2) outpatient pediatrics and 3) pediatric ICU, 4) community pediatrics]. How many PLAs do I need? What about goals and objectives?
Rotations 1,2, and 3 are all at the same participating site [Participating Site A] while the 4th rotation (community pediatrics) is at Participating Site B. Both participating sites are in the master affiliation list below.
- Two of the rotations [inpatient pediatrics, 2) outpatient pediatrics] have the same local/site director [Dr. X] who is part of University Faculty Pediatric Practice. PRG 1, PRG 2, and PRG 3 all rotate through both rotations.
- The third rotation [3) pediatric ICU] has a different local/site director (Dr. Y) who is part of the University Faculty PICU Practice Group. Only PRG1 and PRG 2 rotate through the PICU.
- The fourth rotation [4) community pediatrics] has a different local/site director (Dr. Z) who is at ABC County Health Department. Only PRG1 and PRG 2 rotate through community pediatrics. This rotation is only with an individual and not a group.
ANSWER: Three PLAs are needed. PLAs need to be by Participating Site, by Site Director and by Rotation. For example:
- PLA 1
- will be at Participating Site A,
- will list the names of two rotations (Inpatient Pediatrics, Outpatient Pediatrics),
- will List Dr. X as the Local/Site Director;
- will list the group University Faculty Pediatric Practice for Supervision and Oversight Responsibilities.
- Two sets of Goals and Objectives will be attached. One set for Inpatient Pediatrics (with different goals and objectives for each level of training: PRG1, PRG2, PRG3) and a second set for Outpatient Pediatrics (with different goals and objectives for each level of training: PRG1, PRG2, PRG3.)
- PLA 2
- will be at Participating Site A,
- will list the name of one rotation (Pediatric ICU),
- will List Dr. Y as the Local/Site Director;
- will list the group University Faculty Pediatric ICU Practice for Supervision and Oversight Responsibilities.
- One set of Goals and Objectives will be attached for Pediatric ICU (with different goals and objectives for each level of training: PRG1, PRG2).
- PLA 3
- will be at Participating Site B (ABC County Health Department),
- will list the name of one rotation (Community Pediatrics),
- will List Dr. Z as the Local/Site Director;
- will list Dr. Z as the educator for Supervision and Oversight Responsibilities.
- One set of Goals and Objectives will be attached for Community Pediatrics (with different goals and objectives for each level of training: PRG1, PRG2).
TEMPLATES
A. UF residents/fellows rotating at sites WITH a Master Affiliation Agreement (PLAs)
**NEW ** 12/23/2022 — There is one template to use for any participating site with which the University of Florida has a master affiliation agreement. If you have UF resident/fellow rotations at the sites with a MAA listed below in Section A, use these:
- MAA PLA Template (all MAA sites EXCEPT VA)
- VA MAA PLA Template (only NF/SG VA)
NOTE: Please be sure to submit both the completed PLA including names, but without signatures (including goals and objectives) and all email addresses for everyone required to sign the PLA to the GME Office through the PLA Portal so that the GME Office may route the PLA via DocuSign for signatures.
Participating Sites with a Master Affiliation Agreement:
- Shands Teaching Hospital and Clinics, Inc., UF Health Shands Hospital (Gainesville)
- Central Florida Health, Inc. (UF Health Leesburg Hospital and UF Health The Villages)
- Department of Veterans Affairs — North Florida/South Georgia Veterans Health System (includes Gainesville, Lake City and other NF/SG VA regional sites)
- Naval Hospital — Jacksonville, FL
- Navy Medicine Readiness and Training Command — Jacksonville, FL
- Sacred Heart Health System, Inc. (Ascension Sacred Heart Pensacola – ASHP)
- Sacred Heart Health System, Inc. (Ascension Sacred Heart Emerald Coast – ASHEC)
- Select Specialty Hospital — Gainesville, LLC
- Shands Teaching Hospital and Clinics, Inc., Shands Jacksonville Medical Center, Inc.
- State of Florida, Department of Health, Lake County Health Department
- State of Florida, Department of Health, Marion County Health Department
B. UF residents/fellows rotating at sites WITHOUT a Master Affiliation Agreement (RAs)
Please use the following templates:
- PLA External Rotation Agreement for One-UF Resident
- PLA External Rotation Agreement for Multiple UF Residents (Note: 10 year contract)
Be sure to request their W9 form to obtain legal name and address.
If the PLA is for an international rotation, please check with the GME office before proceeding.
C. NON-UF or Visiting Residents/Fellows (includes UF Jacksonville and Ascension Sacred Heart) experiences/rotations at programs sponsored through the University of Florida College of Medicine – Gainesville, FL: (RAs)
1. Please use one of the following templates depending on the situation (submit template etc. through PLA portal link above):
- Short Term Rotation Agreement for One External Resident at UF
- Long Term Rotation Agreement for Multiple External Residents at UF (Note: 1 year contract)
2. Be sure to request their W9 form to obtain legal name and address (submit W9 with template, etc. through PLA portal link above).
3. Courtesy Housestaff Checklist link– See listed item under Checklists heading on Resident Checklist page (follow directions on linked website)
4. Log into New Innovations: Resources: More: Intranet Tab: Find “Demographics Required for Manual Entry of External Rotator” link (can also access through NI)
5. ID Proofing – email completed form to DOCOM-UFGME-NI@ad.ufl.edu so it can be uploaded to New Innovations.
Tips
- Be sure to request their W9 form to obtain legal name and address.
- Legal Entity “Institution” name must be used, see “Resources” section below for assistance.
- Non-UF Visiting Residents/Fellows or Courtesy Appointments: please click on the following NI link, log in, and follow the steps on your program’s NI homepage “Onboarding External Rotators”: New Innovations Log In
Resources
Use the links below to assist in completing agreement forms
Look up legal entity of non-governmental institutional names:
Requesting Self Insurance Program (SIP) estimates and payment information for visiting residents/fellows from other institutions:
- Contact: Self Insurance Program Estimate Request
Please note “Estimate Request” in the subject line of the email. The specialty and rotation dates are required for the estimate and also note them in your request. Please enter the estimate amount received in the designated fillable section of the template. - SIP Payments (check or money order, payable to UF Self Insurance Program) should be sent to:
UF JHMHC Self-Insurance Program
Attn: Insurance Services
P.O. Box 112735
Gainesville, FL 32611-2735
For More Information
For any additional questions, please contact us at DOCOM-GME-PLA@ufl.edu, Lori Ackley at (352-594-3970) or ackley.lori@ufl.edu or Lynne Meyer at (352-594-6226) or lynnemeyer@ufl.edu.
This page was last updated on December 19, 2024